Mansfield, Kelly B.

Mansfield, Kelly B. is an sole proprietor health care provider with primary practice located at 109 12Th Ave Rd , Nampa ID 83686-5047. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mansfield, Kelly B. can be contacted via phone (208) 467-9271.

Contact Information

Primary practice address
109 12Th Ave Rd Nampa ID 83686-5047
Fax: (208) 466-3609
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D-3113 Idaho

Profile Details

NPI number 1982616983
LBN Legal business name Mansfield, Kelly B.
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers